Abstract:
OBJECTIVES:To describe the surgical technique and clinical outcomes of high-energy proximal femur fractures treated with a 95-degree angled blade plate. DESIGN:Retrospective case series. SETTING:Single academic Level I trauma center. PATIENT/PARTICIPANTS:Forty-five consecutive patients from March 2012 to April 2017 who sustained a high-energy, unstable proximal femur fracture including (OTA/AO 31-A1, 31-A2, 31-A3, 31-B3, 32-A1a, and 32-C3i). INTERVENTION:Open reduction internal fixation with a 95-degree angled blade plate used in conjunction with an articulated tensioning device. MAIN OUTCOME MEASUREMENTS:Nonunion, malunion, secondary operations, and postoperative infection. RESULTS:Twenty six patients were available for follow-up. The mean age was 43.8 (range 22-86) years, and 81% (21/26) were men. The most common fracture pattern was OTA/AO 31-A3.3. Two fractures were open. The articulated tensioner was used in 100% of cases. Average clinical follow-up was 19.2 (range 7-40) months. Twenty-four of 26 patients (92%) achieved osseous union after the index procedure. One patient underwent nonunion repair, and 2 patients had the blade plate removed as it was symptomatic laterally. No other secondary procedures were performed, and no instances of implant failure were seen. No patients had evidence of a superficial or deep infection. CONCLUSIONS:We found that high-energy proximal femur fractures treated with a 95-degree condylar blade plate and articulated tensioning device had a high rate of union with minimal postoperative complications. Although intramedullary nailing of these fractures remains a preferred treatment modality, the angled blade plate with articulated tensioning device is an excellent option to restore anatomical alignment and obtain bony union in certain highly comminuted fracture patterns. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Berkes MB,Schottel PC,Weldon M,Hansen DH,Achor TSdoi
10.1097/BOT.0000000000001505subject
Has Abstractpub_date
2019-07-01 00:00:00pages
335-340issue
7eissn
0890-5339issn
1531-2291journal_volume
33pub_type
杂志文章abstract:OBJECTIVE:To evaluate objectively the effectiveness of current surgical management of displaced acetabular fractures. To provide insight into how these evaluation methods can be used to identify areas in which improvements in surgery and rehabilitation can be pursued to improve patient outcomes. DESIGN:Consecutive cas...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00001
更新日期:2002-02-01 00:00:00
abstract::Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outco...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000415
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:To compare the Disability of the Arm, Shoulder, and Hand (DASH) and Constant scores, time to union, rate of union, patient cosmetic satisfaction rate, and the need for secondary procedures between 2.7- and 3.5-mm anteroinferior plating for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma A...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182693f32
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients. METHODS:We constructed a Markov decision model using a low-demand, 80-year-old patient as the base case. Costs, health-state utilities, mortality rates, and tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001747
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Screw fixation of the injured syndesmosis restores stability but may reduce motion. The purpose of this study is to determine whether functional outcomes and radiographic results after ankle fracture are affected by the status of the syndesmosis screw. DESIGN:Retrospective review of a consecutive clinical se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a9f7a5
更新日期:2010-01-01 00:00:00
abstract::When attempting to remove an intramedullary nail, the extraction device can fail. This can occur due to stripping of the proximal threads or, more rarely, due to entrapped broken metal devices (impacted cap screws; broken introducers, extractors, or taps). This latter situation is particularly problematic if access to...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199702000-00012
更新日期:1997-02-01 00:00:00
abstract::This study was done to determine whether fixation with the Uppsala internal fixation technique into the subchondral bone of the femoral head in the treatment of cervical hip fractures could lead to elevation of the femoral head cartilage. Combined arthrography and frontal tomography of the hip joint in the plane of th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198909000-00004
更新日期:1989-01-01 00:00:00
abstract::Osteochondromas are one of the most commonly observed benign bone tumors. Although there have been a number of experimental studies carried out to determine the origin of osteochondromas, their etiology remains a controversial issue. A well-documented case is presented in which a displaced Salter-Harris type II physea...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199410000-00013
更新日期:1994-10-01 00:00:00
abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199306000-00009
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the reduction and outcome of selected intraarticular calcaneal fractures treated with percutaneous Essex-Lopresti reduction and fixation. DESIGN:Prospective consecutive series. SETTING:Level one trauma center and tertiary university hospital. PATIENTS/PARTICIPANTS:Twenty-six consecutive patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199809000-00007
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:This study aimed to evaluate the incidence and morphologic features of posterolateral fragments in lateral and bicondylar tibial plateau fractures. DESIGN:This study used retrospective chart and computed tomography (CT) reviews. SETTING:The study was conducted in a university hospital. PATIENTS:All patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000170
更新日期:2015-02-01 00:00:00
abstract::Limb salvage was successful in 25 patients treated for severe grade III upper extremity injuries. In a retrospective review of 20 men and five women, follow-up time averaged 26 months. These high-energy injuries were characterized by massive soft-tissue injury, highly comminuted fractures, and significant neurovascula...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locki...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000646
更新日期:2016-11-01 00:00:00
abstract::Fifteen patients with fractures of the extremities and associated arterial injuries treated from 1976 to 1987 were retrospectively analyzed. Complete ischemia was present in only two cases; in four cases with partial ischemia, the vascular injury presented late after 12 h-14 days. All limbs could be preserved, but com...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199103000-00005
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract::A rare case of a complete fracture-separation of the proximal radial epiphysis is described in a pediatric patient. A further complicating factor is the delay in diagnosis that may worsen prognosis. An emphasis on early detection by physical examination and imaging studies, as well as consideration of treatment option...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199506000-00013
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic reliability, sensitivity, and specificity of the Hawkins sign. The Hawkins sign is a subchondral radiolucent band in the talar dome that is indicative of viability at 6 to 8 weeks after a talus fracture. It is visible in the anterior-posterior view, but seldom appears on lateral ra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318148c665
更新日期:2007-09-01 00:00:00
abstract::Although there is little doubt that arthroplasty of one form or another is appropriate treatment for many patients with a displaced femoral neck fracture, there is ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. In particular, total hip arthroplasty i...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181761490
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to evaluate functional outcome, patient self-assessment, and radiographic outcome at 1 year in displaced three- and four-part proximal humeral fractures (OTA group 11-B2 and 11-C2). DESIGN:Randomized controlled trial. SETTING:Academic medical center. PATIENTS/PARTICIPANTS:Fif...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e31821c2e15
更新日期:2012-02-01 00:00:00
abstract::Opening an abdominal window in a hip spica type of cast can be a troubling maneuver for both orthopaedic surgeon and patient. We present a simple device to create an abdominal window more easily. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200307000-00009
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:Much attention has been given to lower extremity amputations that occur more than 90 days after injury, but little focus has been given to analogous upper extremity amputations. The purpose of this study was to determine the reason(s) for desired amputation and the common complications after amputation for t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182a665f5
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:To identify factors affecting the outcomes of surgery for acetabular fracture in patients over the age of 60 years. DESIGN:Retrospective review of records and radiographs; current examination, radiographs and outcome surveys when possible. SETTING:Academic, Level 1 trauma center. PATIENTS/PARTICIPANTS:For...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200310000-00005
更新日期:2003-10-01 00:00:00
abstract::The standard AO-plate was used as an external fixator in 31 patients with an infected nonunion or open fracture mainly of the upper extremity. With the use of this technique, good stability can be achieved with an inexpensive and relatively simple construction. The low profile of the frame is an advantage for the pati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200301000-00010
更新日期:2003-01-01 00:00:00
abstract::Ipsilateral femoral shaft and tibial plateau fractures, termed a "floating knee" are rare and challenging injuries. There is limited literature guiding the operative technique and the outcomes associated with these injuries. The author's preferred technique is early intramedullary of the femoral shaft fracture with kn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001944
更新日期:2020-09-01 00:00:00
abstract::The application of the pelvic clamp as a tool for emergency stabilization of unstable pelvic ring fractures has proved to be a life-saving procedure. Using correct technique, the pelvic clamp can be applied within a few minutes after the patient's admission. To avoid severe complications (eg, pin perforation into the ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200402000-00008
更新日期:2004-02-01 00:00:00
abstract::Immediate (within 24 h) open reduction and internal fixation of 103 open fractures of one or both bones of the forearm was accomplished in 69 patients between 1980 and 1989. Fifty-four of the 103 patients were reevaluated 1 to 7 years postinjury (average 2.5 years) to determine the efficacy of this treatment. Forty-fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Posttraumatic invasive fungal infections threaten critically injured combat-related injuries and require a combination of extensive surgery and systemic antifungal therapy, along with topical antimicrobials used adjunctively to control the infection. We evaluated the in vitro activity of topical agents in va...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182830bf9
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:To characterize the type and magnitude of lower extremity physical performance deficits in military service members who have undergone rehabilitation after limb salvage or transtibial amputation. DESIGN:Cross-sectional prospective. SETTING:Level I trauma military medical and rehabilitation center. PATIENT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001103
更新日期:2018-04-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00